Expert MMI Response #10

In this scenario, the role I have as a physician is to decide whether I should listen to the parents and not disclose the prognosis to the patient, or to tell the truth. The first step I would take would be to collect information. It’s important to know all the variables and remain non-judgemental before making a final decision. Starting with the parents, I will ask them why they don’t want the patient to know about their prognosis. They might, for instance, think that hearing the prognosis will negatively influence their son’s psychological well-being, which they will want to preserve as much as possible in his final days. From the patient’s perspective, his main concern is to know the truth.

To advance this inquiry, I will need to assess the child’s maturity; in other words, I will have to be able to predict with reasonable accuracy how hearing the news will affect his psychological health. It isn’t fair to assume that the child is incapable of processing the news just because his parents are averse to the prospect of him knowing, or because he is young. To assess his maturity, I will ask him about how he’s feeling, and what he thinks of his condition. It will be important to understand what he already knows before I decide if I should reveal other critical details.

I have two available options: to go against the parent’s wishes and tell the kid, or to respect the parent’s wishes. If my assessment of the child’s maturity reveals that he can understand and appreciate his situation, then I would tell the child. It’s important to reveal the truth to the child in this case since this knowledge has health implications. While a physician should respect admonitions and the wishes of parents of children in a medical context, there are situations where siding with the child is obligatory, as their health is my primary concern. In summary, I would assess the child’s capacity by asking questions about what he knows about his health, probe the parents for information on why they think he shouldn’t be told, and then based on this information, make a decision about revealing the prognosis.

Click to go back to MMI sample questions.

If you’d rather seek our help for MMI prep click here.